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Left Main Revascularization With PCI or CABG in Patients With Chronic Kidney Disease: EXCEL Trial Intravascular Ultrasound to Guide Left Main Stem Intervention: A Sub-Study of the NOBLE Trial Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial Design and rationale for a randomised comparison of everolimus-eluting stents and coronary artery bypass graft surgery in selected patients with left main coronary artery disease: the EXCEL trial Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Left Main Coronary Artery Stenosis: A Systematic Review and Meta-analysis Operator Experience and Outcomes After Left Main Percutaneous Coronary Intervention Sex differences in left main coronary artery stenting: Different characteristics but similar outcomes for women compared with men Impact of Lesion Preparation Strategies on Outcomes of Left Main PCI: The EXCEL Trial Successful bailout stenting strategy against lethal coronary dissection involving left main bifurcation Provisional versus elective two-stent strategy for unprotected true left main bifurcation lesions: Insights from a FAILS-2 sub-study
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Editorial2018 Oct 1;92(4):651-652.

JOURNAL：Catheter Cardiovasc Interv. Article Link

Volume brings value

Gogas BD, Chen SL.

ABSTRACT


  • What the article teaches

    The article highlights the competency of high volume operators across institutions that despite moving to lower volume centers retain their good clinical outcomes.


  • How it will impact practice

  • Although current U.S. based guidelines suggest a volume of at least 50 PCIs annually for operators to retain clinical competency this estimate may be a poor index to guarantee optimal clinical outcomes.


  • What new research/study would help answer the question

    New studies using a comprehensive definition to define an experienced operator from the Asia‐Pacific—a geographic area that has pioneered in complex coronary interventions—need to elute on the threshold of adequate clinical competency stratified according to clinical complexity.

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